Effectiveness of continuous positive airway pressure in lowering blood pressure in patients with obstructive sleep apnea: a critical review of the literature

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorFATURETO-BORGES, Fernanda
dc.contributor.authorLORENZI-FILHO, Geraldo
dc.contributor.authorDRAGER, Luciano F.
dc.date.accessioned2016-10-17T16:35:39Z
dc.date.available2016-10-17T16:35:39Z
dc.date.issued2016
dc.description.abstractObstructive sleep apnea (OSA) is an extremely common comorbid condition in patients with hypertension, with a prevalence of similar to 50%. There is growing evidence suggesting that OSA is a secondary cause of hypertension, associated with both poor blood pressure (BP) control and target organ damage in patients with hypertension. The application of continuous positive airway pressure (CPAP) during sleep is the gold standard treatment of moderate-to-severe OSA and very effective in abolishing obstructive respiratory events. However, several meta-analyses showed that the overall impact of CPAP on BP is modest (similar to 2 mmHg). There are several potential reasons for this disappointing finding, including the heterogeneity of patients studied (normotensive patients, controlled, and uncontrolled patients with hypertension), non-ideal CPAP compliance, clinical presentation (there is some evidence that the positive impact of CPAP on lowering BP is more evident in sleepy patients), and the multifactorial nature of hypertension. In this review, we performed a critical analysis of the literature evaluating the impact of CPAP on BP in several subgroups of patients. We finally discussed perspectives in this important research area, including the urgent need to identify predictors of BP response to CPAP and the importance of precision medicine in this scenario.
dc.description.indexPubMed
dc.identifier.citationINTEGRATED BLOOD PRESSURE CONTROL, v.9, p.43-47, 2016
dc.identifier.doi10.2147/IBPC.S70402
dc.identifier.issn1178-7104
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/16113
dc.language.isoeng
dc.publisherDOVE MEDICAL PRESS LTD
dc.relation.ispartofIntegrated Blood Pressure Control
dc.rightsopenAccess
dc.rights.holderCopyright DOVE MEDICAL PRESS LTD
dc.subjectcardiovascular disease
dc.subjectCPAP
dc.subjecthypertension
dc.subjectsleep apnea
dc.subjecttreatment
dc.subject.otherrandomized controlled-trial
dc.subject.otherplacebo-controlled trial
dc.subject.otherresistant hypertension
dc.subject.othermasked hypertension
dc.subject.othersystemic hypertension
dc.subject.otherarterial stiffness
dc.subject.otherclinical-trial
dc.subject.otherrisk
dc.subject.othercpap
dc.subject.otherbp
dc.subject.wosPeripheral Vascular Disease
dc.titleEffectiveness of continuous positive airway pressure in lowering blood pressure in patients with obstructive sleep apnea: a critical review of the literature
dc.typearticle
dc.type.categoryreview
dc.type.versionpublishedVersion
dspace.entity.typePublication
hcfmusp.citation.scopus31
hcfmusp.contributor.author-fmusphcFERNANDA FATURETO BORGES
hcfmusp.contributor.author-fmusphcGERALDO LORENZI FILHO
hcfmusp.contributor.author-fmusphcLUCIANO FERREIRA DRAGER
hcfmusp.description.beginpage43
hcfmusp.description.endpage47
hcfmusp.description.volume9
hcfmusp.origemWOS
hcfmusp.origem.pubmed27051313
hcfmusp.origem.scopus2-s2.0-84961857198
hcfmusp.origem.wosWOS:000382321600002
hcfmusp.publisher.cityALBANY
hcfmusp.publisher.countryNEW ZEALAND
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